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COVID-19 Rates Higher Among Minority, Socioeconomically Disadvantaged Children

Disparities in COVID-19 mortality may be caused by challenges in accessing health care and other resources, as well as socioeconomic factors that could increase exposure.

Paralleling similar health disparities in adults, a new study has found that minority and socioeconomically disadvantaged children have higher rates of coronavirus disease 2019 (COVID-19).

A press release from Children’s National Hospital noted that studies early in the pandemic found significant disparities in the rates of infection across the United States, but it has been unclear whether those disproportionate rates of infection also extended to children and youth. To investigate this, researchers collected data from between March 21 and April 28, 2020, from a drive-through and walk-up testing site affiliated with Children’s National.

Patients who received tests at the site were between 0 and 22 years of age and had to meet specific criteria, including mild symptoms and either known exposure, high-risk status, a family member with high-risk status, or required testing for work. Physicians referred patients via an online portal that collected basic demographic information, reported symptoms, and the reason for referral.

When analyzing data from the first 1000 patients tested at this site, the investigators found that infection rates differed dramatically between racial and ethnic groups. They found that only approximately 7% of non-Hispanic white children tested positive for COVID-19, whereas approximately 30% of non-Hispanic Black and 46% of Hispanic children were positive.

“You’re going from about 1 in 10 non-Hispanic white children to 1 in 3 non-Hispanic Black children and 1 in 2 Hispanic children,” said researcher Monika Goyal, MD, MSCE, in a statement. “It’s striking.”

The researchers then separated this group of 1000 patients into estimated family income quartiles using data from the American Families Survey, which showed significant disparities among various income levels. Specifically, those in the highest quartile had an approximately 9% infection rate, compared with a 38% infection rate among those in the lowest quartile.

The researchers also found disparities in exposure status, according to a press release. Approximately 10% of patients reported a known exposure to COVID-19, 11% of whom were non-Hispanic white.

Strikingly, the researchers found that non-Hispanic Black children were triple this number. With these clear disparities in mind, the authors are now trying to understand why they occur and how they can be mitigated.

“Some possible reasons may be socioeconomic factors that increase exposure [and] differences in access to health care and resources, as well as structural racism,” Goyal concluded.

REFERENCE

COVID-19 rates higher among minority socioeconomically disadvantaged children [news release]. Children’s National; August 7, 2020. https://childrensnational.org/news-and-events/childrens-newsroom/2020/covid-19-rates-higher-among-minority-socioeconomically-disadvantaged-children. Accessed August 17, 2020.

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